Xa umntwana wakho ethetha, ngaba ukhe uve isandi "sempumlo", ngokungathi ilizwi lakhe liphuma empumlweni yakhe? Ngamanye amaxesha xa esithi oonobumba abafana no "प", "ब", "त" benza isandi esingacacanga, sempumlo? Abazali abaninzi bacinga ukuba oku kuqhelekile, kodwa ngamanye amaxesha kunokubakho isizathu sezonyango emva koko. Ungakhathazeki, namhlanje siza kuthetha ngemeko enjalo.
Ngamafutshane, yintoni i-Velopharyngeal Insufficiency ( VPI )?
Nangona eli gama lisenokuvakala liyinkimbinkimbi kancinci, ingongoma ilula kakhulu. Masiyiqonde le nto.
Khawuthelekelele ukuba kukho ucango phakathi komlomo wethu (umlomo) kunye nocango olungaphakathi kwempumlo yethu (ucango lwempumlo). Lo mnyango siwubiza ngokuba yi-'velipharyngeal sphincter'. Oku ngokwenene yindandatho yemisipha . Xa sithetha okanye siginya, olu cango luvala ngokuqinileyo, luthintela umoya ukuba ungangeni empumlweni yethu. Umzekelo, xa sisithi "isonka", uxinzelelo lomoya olufika kuonobumba u-"p" lwenziwa ngaphakathi emlonyeni wethu. Ngelo xesha, ucango luvaliwe, ngoko umoya awuphumi ungene empumlweni yethu.
Ukungasebenzi kakuhle kwe-Velopharyngeal ( VPI ) yimeko apho loo mnyango, okanye 'i-sphincter', ungavaleki kakuhle. Oko kuthetha ukuba kukho umsantsa omncinci oseleyo. Kwenzeka ntoni ke ngoko? Xa sithetha, umoya othile omele uphume emlonyeni wethu uphuma uye empumlweni yethu. Yiyo loo nto ilizwi lethu livakala ngathi lelempumlo. Kwezinye iimeko ezinzima, linokuphuma nasemlonyeni wethu xa sisela into elulwelo efana namanzi.
Ngamafutshane, i-VPI kuxa umoya uphuma ngempumlo xa uthetha kuba ucango oluphakathi komlomo nempumlo aluvaleki kakuhle.
Ngubani onokuba nethuba elikhulu lokufumana le meko?
Nangona i-VPI inokwenzeka nakubani na, ixhaphake kakhulu ebantwaneni. Kukho izinto ezininzi ezibangela oku.
- Iingxaki zokuzalwa: Abanye abantwana bazalwa beneengxaki ezithile ngenkalakahla yabo. Umzekelo, abantwana abanenkalakahla eqhekekileyo banokuba nale meko. Kwakhona, inkalakahla ethambileyo yabanye abantwana isenokuba mfutshane kancinci xa bezalwa.
- Iitoni ezikhulisiweyo kunye nee-adenoids : Kwabanye abantwana, xa iitoni ezisemphinjeni okanye ii-adenoids ezingasemva kwempumlo zikhula, oku kunokuphazamisana ne-'sphincter' esiyikhankanyileyo.
- Iimeko zofuzo: I-Down syndromeI-VPI inokwenzeka nakwiimeko ezithile zemfuza, ezifana ne-Down syndrome okanye i-neurofibromatosis.
- Ubuthathaka bemisipha: Izifo zemithambo-luvo ezifana ne-cerebral palsy zinokubangela ukuba izihlunu zentloko zibe buthathaka kwaye zingasebenzi kakuhle.
- Ezinye iindlela zotyando:
- Utyando lwe-Adenoid.
- Utyando lweetoni.
- Utyando lokususa izicwili ngasemva komphimbo (UPPP surgery) kwiimeko ezifana nokurhona .
- Ezinye izizathu: Ukuba nethumba ekhayeni okanye ukufumana unyango lwemitha yomhlaza womqala/impumlo nako kunokubangela i-VPI.
Amaxesha amaninzi, iimvumi ezidlala izixhobo zomculo zebrass okanye zomoya womthi zinokuba nesifo sexeshana esibizwa ngokuba yi-"stress VPI" ngenxa yoxinzelelo.
Zithini iimpawu zomntu one-VPI?
Ukuba ukrokrela ukuba umntwana wakho une-VPI, hlala ulumkele ezi mpawu.
| Uphawu | Ingcaciso elula |
|---|---|
| Ilizwi elivakala ngathi lempumlo | Olu luphawu oluphambili. Xa uthetha, ilizwi lakho livakala ngathi liphuma empumlweni yakho, ngokungathi unesifo somkhuhlane. Oku sikubiza ngokuba yi-'hypernasal speech'. |
| Ubunzima bokubiza oonobumba abathile | Kunzima kakhulu ukubiza oonobumba abafuna uxinzelelo emlonyeni, abanjengo-'pa', 'ba', 'ta', 'da', 'ka', kunye no-'ga', kuba umoya uphuma ngempumlo. |
| Izandi zempumlo xa uthetha | Ngelixa uthetha, usenokuva ingxolo efana nomoya ovuthuzayo empumlweni yakho, isandi esithi 'shhh', okanye isandi esifana nempumlo yakho sivaliwe. |
| Ukubuyela umva kwesisu (ukutya/ulwelo oluphuma ngempumlo) | Le yinto enokubonwa kwiimeko ezinzima ngakumbi. Xa usela into efana namanzi okanye ubisi, ingaphuma ngeempumlo zakho. |
Ilizwi livakala njani kwimeko ye-VPI?
Ukuze kucace gca, xa umntu onesi sifo ethetha, unokuva izinto ezinje:
- Ibali libonakala ngathi libambeke embindini, kwaye ibali liyayeka ngendlela engaqhelekanga.
- Ilizwi alicacanga, libonakala ngathi livalekile (intetho evalekile).
- Xa uthetha, usenokuva isandi 'sokukhafula', isandi 'sokukrwitsha', okanye isandi 'sokukrwitsha', ngokungathi impumlo yakho ivalekile .
- Kuvakala ngathi uthetha ngempumlo yakho endaweni yomlomo wakho.
Ungayibona njani le meko?
Ukuba ubona ezi mpawu kumntwana wakho, eyona nto ingcono onokuyenza kukubona ugqirha. Ingcali yendlebe, impumlo, nomqala (ENT surgeon) ngumntu ofanelekileyo koku. Uza kwenza iimvavanyo ezininzi ukuqinisekisa imeko.
1. Uvavanyo lomzimba: Okokuqala, ugqirha uza kuyichukumisa inkalakahla yomntwana ukuze abone ukuba kukho naziphi na iingxaki.
2. Uhlalutyo lwentetho: Vumela umntwana athethe aze amamele ngononophelo izandi eziqhelekileyo ze-VPI.
3. I-Nasoendoscopy: Kule nto, kufakwa ityhubhu encinci, eguquguqukayo enekhamera kunye nokukhanya empumlweni aze ugqirha ajonge ngqo kwiscreen ukuze abone ukuba i-sphincter iyavalwa na xa uthetha okanye kukho naziphi na izikhewu. Nangona oku kungabonakala kungathandeki kancinci, kubaluleke kakhulu ekufumaneni uxilongo oluchanekileyo.
4. I-Videofluoroscopy: Olu luvavanyo olukhethekileyo lwe-X-ray. Umntwana unikwa ulwelo olubizwa ngokuba yi-barium ukuba alusele, kwaye i-X-ray ibonisa intshukumo yeendawo zomlomo nomphimbo njengoko ziginya kwaye zithetha.
Ziziphi iindlela zonyango ze-VPI?
Xa imeko ye-VPI iqinisekisiwe, akukho nto yokoyika. Kukho unyango olusebenzayo koku. Iindlela zonyango zinokwahlulwa zibe ziindidi ezimbini eziphambili.
1. Unyango lweNtetho
Le yinxalenye ebaluleke kakhulu. Ingcali yezentetho ifundisa umntwana indlela yokuthetha nge-VPI ngendlela enciphisa isandi sempumlo kwilizwi. Ngamanye amaxesha, unyango lwentetho luyadingeka ngaphambi nasemva kotyando. Emva kotyando, umntwana kufuneka afunde ukubiza izandi ngendlela entsha.
2. Utyando
Kwiimeko ezininzi, isisombululo esihlala sihleli kwi-VPI lutyando. Injongo ephambili yotyando kukuvala umsantsa phakathi kwempumlo nomlomo. Nangona kunjalo, kufuneka kuthathwe unonophelo ukuze kungathinteli ukuphefumla kwempumlo. Ngokuxhomekeke kwimeko yomntwana, ugqirha angasebenzisa iindlela ezahlukeneyo zotyando.
- Ukutshintsha imo yenkalakahla ethambileyo.
- Ukwenza udonga lomqala lube lukhuni kancinci kwaye kunciphisa umgama oya emlonyeni.
- Ukolula okanye ukuqeqesha kwakhona izihlunu zesandla.
- I-flap yemisipha (`pharyngeal flap`) ithathwa eludongeni olungasemva lomqala ize incamathiselwe eluphahleni lomlomo. Oku kuvala umsantsa kakhulu.
Ngamanye amaxesha, kwabo bangakwaziyo okanye abangafuni utyando, kufakwa isixhobo esikhethekileyo (`ukufakelwa ngomlomo`) emlonyeni, njengesibambi esibekwa emazinyweni. Oku kwenzelwa ukutyhala uphahla lomlomo phezulu nokuvala umsantsa. Nangona kunjalo, kunokuba nzima kancinci ukuzisebenzisa rhoqo.
Ngaba kukho naziphi na iingozi zotyando?
Njengalo naluphi na utyando, utyando lwe-VPI lunokuba neengozi ezincinci, kodwa ezi azenzeki kwiimeko ezininzi.
- Intetho ye-Hyponasal: Oku kuthetha ukuba emva kotyando, isandi esiphuma empumlweni siba sibi kunesiqhelo, kwaye ilizwi livakala ngathi livela kumkhuhlane.
- Ubunzima bokuphefumla ngempumlo.
- Ukurhona kunye nokuphelelwa ngamandla komoya xa ulele.
- Ngamanye amaxesha, nasemva kotyando, ilizwi lempumlo (intetho ye-hypernasal) lisenokunganyamalali ngokupheleleyo, kodwa lisenokukhula.
Ugqirha wakho uza kuxoxa nawe ngale nto ngokweenkcukacha ngaphambi kotyando.
Utyando lwe-VPI luphumelele ngama-85%, oko kuthetha ukuba ipesenti enkulu yabantwana iyaphila kakuhle. Nangona kunjalo, abanye basenokuqhubeka benazo iimpawu okanye basenokufuna olunye utyando.
Ndingenza ntoni ukuba umntwana wam unale meko?
Eyona nto ibalulekileyo ekufuneka uyenze kukubona ugqirha ngokukhawuleza kwaye ucele ingcebiso. Ukuba ubona iipatheni ezingaqhelekanga, imikhwa, okanye izandi kwintetho yomntwana wakho, ingakumbi ukuba ilizwi livakala ngathi lelempumlo, musa ukulityeshela.
Kuba xa le meko inyangwa ngokukhawuleza, iziphumo ziya kuba ngcono. Ukuba akunjalo, umntwana unokuba nomkhwa wokuthetha ngendlela engafanelekanga kwaye kunokuba nzima ukutshintsha loo mkhwa kamva.
Akukho ndlela ithile yokuthintela le meko, njengoko idla ngokuzalwa okanye ibangelwa zezinye iimeko zonyango.
Umyalezo Wokuya Ekhaya
- Ukungakwazi ukusebenza kakuhle kwemithambo yegazi (i-VPI) yimeko apho umngxuma wemisipha phakathi komlomo nempumlo ungavaleki kakuhle, nto leyo ebangela ukuba umoya ungene empumlweni xa uthetha.
- Uphawu oluphambili kukuba ilizwi livakala ngathi livela empumlweni (ilizwi 'lempumlo'). Kusenokuba nzima nokubiza oonobumba abanjengo 'প', 'ব', kunye no-'ত'.
- Oku kunokubangelwa zizinto ezifana ne-cleft palate, i-adenoids ekhulisiweyo, kunye notyando oluthile.
- Ukuba ubona utshintsho olunje kwindlela umntwana wakho athetha ngayo, musa ukulutyeshela uze ubone ugqirha ngoko nangoko.
- Unyango lokuthetha kunye notyando lunokuba luncedo kakhulu ekunyangeni le meko. Unyango lwasekuqaleni lubonelela ngeziphumo ezilungileyo.
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